scholarly journals Evidence for the Use of Acellular Dermal Matrix in Implant-Based Breast Reconstruction

2019 ◽  
Vol 33 (04) ◽  
pp. 229-235 ◽  
Author(s):  
Paula R. Gravina ◽  
Rowland W. Pettit ◽  
Matthew J. Davis ◽  
Sebastian J. Winocour ◽  
Jesse C. Selber
Keyword(s):  
Breast Reconstruction ◽  
Capsular Contracture ◽  
Acellular Dermal Matrix ◽  
Patient Specific ◽  
Dermal Matrix ◽  
Biological Scaffolds ◽  
Dermal Matrices ◽  
Tissue Grafts ◽  
Cellular Components ◽  
Acellular Dermal

AbstractAcellular dermal matrices (ADMs) are tissue grafts that have been specially processed to remove all cellular components. These machined biological scaffolds have become popular in a variety of surgical settings due to their rapid incorporation into living tissue. As ADMs are highly malleable and cause minimal inflammation, they have come to serve as a useful tool in implant-based breast reconstruction procedures. The major benefits of using an ADM in this setting include superior initial breast contouring, decreased risk of capsular contracture after implant insertion, and consistent sustained positioning of the reconstructed breast. Despite these advantages, these tissue grafts are foreign to the host, and postoperative complications following ADM insertion, including infection and seroma, have been well documented. When considering using ADMs in this setting, it is important to first consider patient-specific factors that could preclude their use, such as low body mass index, small breasts, or a history of radiation exposure to the breast tissue. ADM grafts are also expensive, which may present another barrier to their use. Review of the literature ultimately suggests a continued role for ADMs in implant-based breast reconstruction, and continued research in this field is warranted.

scholarly journals Acellular dermal matrices in immediate breast reconstruction: a literature review

2021 ◽  
Vol 8 (2) ◽  
pp. 933
Author(s):  
Mohammed Attallah Alharbi ◽  
Fahad K. Aljindan ◽  
Reshan Mane Al Reshan ◽  
Khalid Dakhelallah Almutairi ◽  
Fatimah Mofeed Almosabh ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Reconstructive Surgery ◽  
Capsular Contracture ◽  
Acellular Dermal Matrix ◽  
Immediate Breast Reconstruction ◽  
Dermal Matrix ◽  
Different Types ◽  
Dermal Matrices ◽  
Breast Reconstructive Surgery ◽  
Acellular Dermal

There has been an increase in invasive breast carcinoma which many times end up with a mastectomy. The psychological effects of mastectomy can be overwhelming, urging the need for optimum breast reconstruction procedures. Acellular dermal matrices are widely used nowadays due to their favorable outcomes with a few complications. In this study, we review the literature to explore the different types used, cons, and pros of this procedure. Databases like PubMed, Medline, Web of science, Embase, Google scholar, and Scopus were used and searched for following terms “implant-based reconstruction” or “breast reconstruction” or “acellular dermal matrix”. All studies that discuss the use of acellular dermal matrices for breast reconstructive surgery were included. Acellular dermal matrices may allow a relatively easy, affordable and time-efficient breast reconstructive surgery. They are associated with less incidence of infection and capsular contracture making them an excellent fit for most procedures. However, m ore studies are needed to help understand possible risk factors, and complications and how to avoid them.

Ancillary considerations in breast surgery

2021 ◽  
pp. 1145-1150
Author(s):  
Emily G. Clark ◽  
Melissa A. Mueller ◽  
Gregory R.D. Evans
Keyword(s):  
Breast Reconstruction ◽  
Breast Surgery ◽  
Capsular Contracture ◽  
Acellular Dermal Matrix ◽  
Fat Grafting ◽  
Dermal Matrix ◽  
Oncological Safety ◽  
Acellular Dermal ◽  
Radiographic Changes ◽  
Suspicious Lesions

Debated topics and new and evolving techniques in breast surgery are discussed in this chapter. Antibiotics and the use of closed-suction drains vary among surgeons, but the existing evidence favours discontinuation of antibiotics within 24 hours in most cases, and the indications for drains are limited but include breast reconstruction with acellular dermal matrix (ADM). ADM is a biological tissue substitute with many applications in breast surgery. The product selected and surgical technique used are often case specific; cost and patient anatomy play major roles. Although not suitable for all patients, ADM is an asset to prosthetic breast reconstruction. In addition, ADM is useful in the correction of breast surgery complications, including malpositioning and capsular contracture. It may be combined with fat grafting to mask rippling. Fat grafting, or lipomodelling, is an evolving science with promising results. Technique is critical for good results, and is described in this chapter. Radiographic changes after fat grafting are usually discernible from suspicious lesions, and growing evidence supports the oncological safety of this procedure

scholarly journals Does Acellular Dermal Matrix Thickness Affect Complication Rate in Tissue Expander Based Breast Reconstruction?

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jessica F. Rose ◽  
Sarosh N. Zafar ◽  
Warren A. Ellsworth IV
Keyword(s):  
Breast Reconstruction ◽  
Skin Necrosis ◽  
Tissue Expander ◽  
Retrospective Chart Review ◽  
Acellular Dermal Matrix ◽  
Complication Rates ◽  
Dermal Matrix ◽  
Drain Removal ◽  
Dermal Matrices ◽  
Acellular Dermal

Background. While the benefits of using acellular dermal matrices (ADMs) in breast reconstruction are well described, their use has been associated with additional complications. The purpose of this study was to determine if ADM thickness affects complications in breast reconstruction. Methods. A retrospective chart review was performed including all tissue expander based breast reconstructions with AlloDerm (LifeCell, Branchburg, NJ) over 4 years. We evaluated preoperative characteristics and assessed postoperative complications including seroma, hematoma, infection, skin necrosis, and need for reintervention. We reviewed ADM thickness and time to Jackson-Pratt (JP) drain removal. Results. Fifty-five patients underwent 77 ADM-associated tissue expander based breast reconstructions, with average age of 48.1 years and average BMI of 25.9. Average ADM thickness was 1.21 mm. We found higher complication rates in the thick ADM group. Significant associations were found between smokers and skin necrosis (p<0.0001) and seroma and prolonged JP drainage (p=0.0004); radiated reconstructed breasts were more likely to suffer infections (p=0.0085), and elevated BMI is a significant predictor for increased infection rate (p=0.0037). Conclusion. We found a trend toward increased complication rates with thicker ADMs. In the future, larger prospective studies evaluating thickness may provide more information.

Breast Reconstruction with Implants and Tissue Expanders

2019 ◽  
pp. 669-676
Author(s):  
Ruth J. Barta ◽  
Omotinuwe Adepoju ◽  
Bruce Cunningham
Keyword(s):  
Breast Reconstruction ◽  
Acellular Dermal Matrix ◽  
Fat Grafting ◽  
Implant Design ◽  
Patient Specific ◽  
Dermal Matrix ◽  
Tissue Expanders ◽  
Aesthetic Results ◽  
The Aesthetic ◽  
Acellular Dermal

This chapter details breast reconstruction following breast surgery. Over the past decade the number of women choosing reconstruction with tissue expanders and implants has steadily increased, while the percentage of women having autologous reconstruction has plateaued or fallen off. The authors explain the use of tissue expanders and implants and detail the advancements made in the ability to evaluate tissue in real-time intervals. Additional advances in technique, implant design, acellular dermal matrix, and fat grafting have improved the aesthetic results of breast reconstruction even further, and these techniques are discussed in detail. The authors address patient-specific indications and contraindications, the use of acellular dermal matrix, the assessment of the defect and perfusion, patient markings, room setup, and operative technique.

scholarly journals Evaluation of Complication Rates after Breast Surgery Using Acellular Dermal Matrix: Median Follow-Up of Three Years

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Felix J. Paprottka ◽  
Nicco Krezdorn ◽  
Heiko Sorg ◽  
Sören Könneker ◽  
Stiliano Bontikous ◽  
...  
Keyword(s):  
Capsular Contracture ◽  
Composite Endpoint ◽  
Acellular Dermal Matrix ◽  
Complication Rates ◽  
Dermal Matrix ◽  
Long Term Follow Up ◽  
Retrospective Data Collection ◽  
Dermal Matrices ◽  
Acellular Dermal

Introduction. Acellular dermal matrices (ADMs) are now commonly used for breast reconstruction surgery. There are various products available: ADMs derived from human (HADM), porcine (PADM), or bovine (BADM) sources. Detailed long-term follow-up studies are necessary to detect differences in complication rates between these products. Material and Methods. From 2010 to 2015, forty-one patients underwent 52 ADM-breast reconstructions in our clinic, including oncologic breast reconstructions and breast augmentation revisions (n=52). 15x HADMs (Epiflex®/DIZG), 21x PADMs (Strattice®/LifeCell), and 16x BADMs (Tutomesh®/RTI Surgical) were implanted. Retrospective data collection with median follow-up of 36 months (range: 12–54 months) was performed. Results. Overall complication rate was 17% after ADM implantation (HADM: 7%; PADM: 14%; BADM: 31%). In a composite endpoint of complications and Red Breast Syndrome, a lower event probability was observed between BADMs, PADMs, and HADMs (44%, 19%, and 7%, resp.; p=0.01 for the trend). Furthermore, capsular contracture occurred in 6%, more frequently as compared to the current literature. Conclusions. When ADM-based reconstruction is indicated, the authors suggest primarily the use of HADMs and secondary the use of PADMs. It is shown that BADMs have the highest complication probability within our patient cohort; nevertheless, BADMs convey physical advantages in terms of flexibility and better aesthetic outcomes. The indication for the use of ADMs should be filled for each case individually.

scholarly journals Sterile Acellular Dermal Collagen as a Treatment for Rippling Deformity of Breast

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Brittany Busse ◽  
Hakan Orbay ◽  
David E. Sahar
Keyword(s):  
Breast Reconstruction ◽  
Ductal Carcinoma ◽  
Capsular Contracture ◽  
Skin Flap ◽  
Acellular Dermal Matrix ◽  
Breast Implants ◽  
Matrix Product ◽  
Dermal Matrix ◽  
Acellular Dermal

Prosthetic implants are frequently used for breast augmentation and breast reconstruction following mastectomy. Unfortunately, long-term aesthetic results of prosthetic breast restoration may be hindered by complications such as rippling, capsular contracture, and implant malposition. The advent of use of acellular dermal matrices has greatly improved the outcomes of prosthetic breast reconstruction. We describe a case of rippling deformity of breast that was treated using an acellular dermal matrix product, AlloMax. The patient presented with visible rippling of bilateral prosthetic breast implants as well as significant asymmetry of the breasts after multiple excisional biopsies for right breast ductal carcinoma in situ. A6×10 cm piece of AlloMax was placed on the medial aspect of each breast between the implant and the skin flap. Follow-up was performed at 1 week, 3 months, and 1 year following the procedure. The patient recovered well from the surgery and there were no complications. At her first postoperative follow-up the patient was extremely satisfied with the result. At her 3-month and 1-year follow-up she had no recurrence of her previous deformity and no new deformity.

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